Health insurer Aetna Inc. will stop selling individual Obamacare plans next year in 11 of the 15 states where it had been participating in the program, joining other major insurers who’ve pulled out of the government-run markets in the face of mounting losses.
It will exit markets including North Carolina, Pennsylvania and Florida, and keep selling plans in Iowa, Delaware, Nebraska and Virginia, Aetna said in a statement Monday. In most areas it’s exiting, Aetna will offer individual coverage outside of the program’s exchanges.
Barred from restaurants, banned on airplanes and unwelcome in workplaces across America, smokers have become accustomed to hiding their habits. So it’s no surprise many may now also be denying their habit when they buy health coverage from the federal health law’s insurance exchanges.
Insurers, who can charge higher rates in most states to admitted smokers, are steamed.
As some of the nation’s largest health insurance companies grapple with mounting claims from the sickest Americans buying individual coverage under the Affordable Care Act, the Obama administration said today it is “exploring options” to help health plans adjust for these patients.
Health Insurance Marketplace CEO Kevin Counihan is looking at ways to improve the “permanent risk adjustment program” that helps insurers cope with the sickest of patients. Insurers including Aetna, Anthem, Humana and UnitedHealth Group are complaining they are losing hundreds of millions of dollars because there are an extraordinary number of sick patients with greater needs than they anticipated.
Obamacare has provided health insurance to some 20 million people. But are they any better off?
This has been the central question as we’ve been watching the complex and expensive health law unfurl. We knew the law was giving people coverage, but information about whether it’s protecting people from debt or helping them become more healthy has been slower to emerge.
A few recent studies suggest that people have become less likely to have medical debt or to postpone care because of cost. They are also more likely to have a regular doctor and to be getting preventive health services like vaccines and cancer screenings.
Joe Cortelli, a health insurance expert from the nationwide consulting group HIG, explains:
“We have done nothing to improve the outcomes of the 10% of the population that drives 80% of our claims costs. We have merely pumped billions of dollars into these [ObamaCare] exchanges masking the real problems. Unless the government can continue to pump money into these exchanges, the end result is not that hard to imagine. It is not a question of how, but when, this will all come home to roost.”
The facts support this. Millions of previously uninsurable sick people are flooding the insurance market, driving premiums sky high. As noted in the Fiscal Times, “The combination of market forces and limitations imposed by the [ACA] will put enormous pressure on insurers to up their premiums.” The pressure on insurers is undeniable, including the $650 million losses recently reported by UnitedHealth.
Investor’s Business Daily in an editorial says that the following predictions from Obamacare critics actually came true: Young people would opt to pay the penalty instead of getting insurance, premiums and medical claims would increase, people would wait until they got sick to buy insurance and cancel the plan after the bills were paid and insurers would leave Obamacare after they lost money.
Come 2017, thousands of New York’s Obamacare users will wake up to double-digit premium hikes, the latest group of consumers affected by Affordable Care Act cost increases as insurers hemorrhage money from healthcare exchanges.
In a statement on Friday announcing 2017 premiums, NY’s Department of Financial Services (DFS) said after weighing insurer requests, the state settled on an average hike of 16.6 percent for individual exchange users in the state, while small group users will see a lower average increase of over 8 percent.
Poor Americans in states that have expanded Medicaid through the Affordable Care Act are going to the doctor more often and having less trouble paying for it, new research finds.
At the same time, two years of experience with the expansion offer additional indications that the improved access to care will ultimately improve patients’ health, a key goal of 2010 law, often called Obamacare.
With some embarrassment, Covered California (the state’s Obamacare exchange where people can purchase health coverage) has announced the average premium hike next year will be 13.2 percent. For many subscribers, the hike will be much greater because of the way federal tax credits discount premiums.
This year, a 40-year-old single person making between $17,820 and $23,760, can buy a Blue Shield Silver level plan with a monthly premium of $318. However, the subscriber only pays $122 while the federal government chips in $196. Next year, the premium will go up 20 percent to $381, of which the subscriber will pay $170, while the government will chip in $211. The total premium will increase by 20 percent ($63), while the subscriber’s net premium will increase 39 percent ($48).
I was wrong. Wrong about an important part of Obamacare.
When I joined the Obama White House to advise the president on health-care policy as the only physician on the National Economic Council, I was deeply committed to developing the best health-care reform we could to expand coverage, improve quality and bring down costs. We worked for months to pass this landmark legislation, and I still count celebrating the passage of the Affordable Care Act with the president one balmy spring night in 2010 as one of my greatest Washington memories.
What I got wrong about Obamacare was how the change in the delivery of health care would, and should, happen.